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BMC Psychiatry

, 17:168

Psychotic disorders


BackgroundUsing paradigms from game theory, researchers have reported abnormal decision-making in social context in patients with schizophrenia. However, less is known about the underpinnings of the impairment. This study aimed to test whether theory of mind ToM deficits and-or neurocognitive dysfunctions mediate impaired social decision-making in patients with schizophrenia.

MethodsWe compared thirty-five patients with schizophrenia to thirty-eight matched healthy controls with regard to social decision-making using the mini Ultimatum Game mini UG, a paradigm from game theory. Additionally, we assessed ToM using the Theory of Mind Picture Stories Task, a mental state attribution task, and assessed neurocognition using the Brief Assessment of Cognition in Schizophrenia. Mediation analyses were performed on the data.

ResultsIn contrast to the behavioral pattern of healthy controls in the mini UG, the patients with schizophrenia significantly accepted more disadvantageous offers and rejected more advantageous offers, and showed reduced sensitivity to the fairness-related context changes in the mini UG. Impaired ToM and neurocognition were also found in the patients. Mediation analyses indicated that ToM but not neurocognition partially mediated the group differences on the disadvantageous and advantageous offers in the mini UG.

ConclusionsPatients with schizophrenia exhibited impaired social decision-making. This impairment can be partly explained by their ToM deficits rather than neurocognitive deficits. However, the exact nature of the ToM deficits that mediate impaired social decision-making needs to be identified in future.

KeywordsSocial decision-making Theory of mind Neurocognition Schizophrenia Mini ultimatum game AbbreviationsANCOVAAnalysis of Covariance

BACSBrief Assessment of Cognition in Schizophrenia.

GAFGlobal Assessment of Functioning

PSPPersonal and Social Performance

SANSScale for Assessment of Negative Symptoms

SAPSScale for Assessment of Positive Symptoms

TMPSTTheory of Mind Picture Stories Task

ToMTheory of Mind

UGUltimatum Game

Electronic supplementary materialThe online version of this article doi:10.1186-s12888-017-1313-3 contains supplementary material, which is available to authorized users.

Autor: Liuqing Yang - Peifu Li - Haiying Mao - Huiling Wang - Chang Shu - Vibeke Bliksted - Yuan Zhou


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